Summary The transformational advances in cancer biology and technologies to characterize cancers at a molecular level, combined with the rapid expansion of novel drugs and cellular therapies, mandates a fundamental re- evaluation of clinical trial design and delivery to ensure maximal patient and societal benefits. The Canadian Cancer Trials Group (CCTG) has strong partnerships with US investigators and groups within the NCTN, which emphasize international collaboration to conduct definitive practice-changing trials, trials in rare cancers settings, and trials testing precision-medicine strategies. As the Canadian Collaborating Clinical Trials Network (CCCTN) of the NCTN, CCTG expands NCTN's scientific expertise by: 1) Involving the best and brightest within its network in NCTN leadership roles; 2) Increasing clinical trial capacity through its national network, which includes all centres in Canada; and, 3) Facilitates access to Canadian patients, which is particularly important for trials testing interventions in rare populations. CCTG contributes to scientific concept development, accrual, biospecimen collection, and network leadership, and has expertise in instrumental components of trial conduct (including information technology and regulations). CCTG develops and participates in NCTN adult cancer trial portfolios in breast, lung, urological, and gastrointestinal malignancies, in uncommon/rare settings of unmet need such as hematological, skin, brain and head and neck cancers, and includes adolescents and young adults on AYA trials. In addition, CCTG capitalizes on opportunities to extend its scope of trial activity to include surgical and lifestyle interventions and imaging and digital health endpoints. Research incorporates translational science and other correlative endpoints to enrich information derived from NCTN trials and methods and technology development to improve clinical trial designs, endpoints, and execution. Finally, CCTG contributes trial datasets from NCTN trials as part of its data sharing policy. As the CCCTN, CCTG, Canada's largest and most experienced clinical trials unit, creates and delivers innovative strategies that arise from the NCTN accelerating the translation of scientific advances into improvements in cancer treatments improving the lives of children, adolescents, and adults diagnosed with cancer.